This is a renewal application for a highly successful, interdisciplinary, T32 training program. The purpose of this program is to build a critical mass of outstanding postdoctoral scientists, primarily epidemiologists, health services researchers, behavioral scientists, and academic clinicians, to produce the evidence that will guide optimum, efficient, and cost-effective healthcare practices for older women. In the coming years, older women will consume a disproportionate amount of the nation's health care resources. By 2030, 70 million, or 1 in 5 Americans, will have reached their 65th birthday. Women live longer than men and thus outnumber men especially in older age groups. At every age over 65, women's disabled life expectancy is doubled that of men and their institutionalized life expectancy is 3-4 fold longer than men. Medicare expenditures are 7-23% higher and nursing home expenditures are 60-100% higher for older women than men. The training program is housed in the Group Health Research Institute, a nationally recognized leader in health care innovation. Trainees have access to a broad range of resources, including an invigorated scientific community, formal, and informal coursework, and degree granting programs. The program and its faculty are closely linked with the Departments of Epidemiology and Health Services at the University of Washington and the Fred Hutchinson Cancer Research Center. We will continue the training program with recruitment of 7 new postdoctoral fellows over the next 5-year period. Women's health faculty at GHRI have a rich program of research focused in areas critically important to improving healthcare for aging women including: 1) screening and preventive services; 2) bone health; 3) urinary health; 4) the menopausal transition; 5) chronic disease prevention and management; and 6) frailty and disability. Twenty faculty preceptors will participate. The training program has 8 primary learning objectives: 1) Develop skills in defining research questions and appropriate study designs; 2) Acquire basic knowledge in the 6 aforementioned research focus areas in women's health; 3) Acquire in-depth expertise in one or more research domains relevant to healthcare improvement for aging women; 4) Complete training in protection of human subjects; 5) Gain experience implementing research protocols; 6) Improve skills in making scientific presentations; 7) Improve skills in scientific writing and publishing; 8) Develop skills in grant writing. To date, we have appointed 6 postdoctoral fellows from multidisciplinary scientific areas (epidemiology, pharmacy, nutrition, demography, social work) and diverse race/ethnicity groups (2 Caucasian, 2 Asian, 1 Native American, 1 Black). Three fellows have completed the program and accepted junior faculty positions at excellent universities, 3 are current trainees, and two have successfully competed for K-awards. Over the long term, this training program will build a cohort of outstanding public health scientists prepared to have major impacts on health care delivery for aging women. PUBLIC HEALTH RELEVANCE: Women live longer than men but in every age group over 65, women's disabled life expectancy is doubled that of men and their institutionalized life expectancy is 3-4 fold longer than older men. The purpose of this training program application is to prepare postdoctoral public health scientists, primarily epidemiologists, health services researchers, behavioral scientists, and academic clinicians, to produce the evidence that will guide optimum, efficient, and cost-effective healthcare practices for older women in the future. We propose to continue this successful training program with recruitment of 7 new postdoctoral fellows over the next 5-year period.